Individual
CHONGSUH BAE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
1160 SOPWITH CT, BENBROOK, TX 76126-4284
(817) 353-0132
Mailing address
1160 SOPWITH CT, BENBROOK, TX 76126-4284
(817) 353-0132
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1044451
TX
Other
Enumeration date
03/01/2022
Last updated
03/01/2022
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